A Biopsychosocial Examination of Transcatheter Aortic Valve Replacement Health Outcomes

Abstract

Cardiovascular disease (CVD) is the leading cause of death in the world accounting for 17.3 million deaths annually. Transcatheter aortic valve replacement (TAVR) was developed 13 years ago to treat people suffering from one of the most common manifestations of CVD, valve disease. While preliminary research has indicated that physiological benefits of TAVR are favorable, psychosocial benefits and psychosocial predictors for physical and psychological outcomes have received less attention. In the current study, TAVR patients (N = 34) were queried on a number of biopsychosocial factors at baseline and three months post-op. Results revealed substantial improvement in both general and disease specific QOL post-TAVR as measured by the SF-12 PCS (z = -2.84, p = .004, r = .69) and KCCQ (z = -3.36, p = .001, r = .84). There was also a decrease in anxiety as measured by the HADS (z = -2.47, p = .014, r = .58) and dyspnea as measured by selected items of the UCSD-SOBQ (z = -3.01, p = .003, r = .71). Biopsychosocial factors that were most strongly associated with the greatest improvement in disease specific QOL post-TAVR were low baseline scores on the KCCQ (r = -.811, p < .01), low levels of physical activity (r = -.625, p < .05), and worse dyspnea (r = .620, p < .05). Contrary to hypothesis, there was no significant association between baseline levels of positive expectations, satisfaction with life, or psychological distress, with post-op QOL improvement. Overall, results suggest that patients may experience meaningful gains in QOL post-TAVR and, in fact, those patients who report the worst biopsychosocial health at baseline may likely experience the most substantial QOL improvements.